Benefits Column

It takes more than individual and employer efforts to change long-term health outcomes, experts say. It takes community involvement, social-support systems and a sense of purpose. A healthcare and lifestyle initiative in the Beach Cities of California is based on that philosophy.

I'm a long-time Malcolm Gladwell fan -- dating back to his early days as a New Yorkerwriter, before The Tipping Point took off as a bestselling book. I like how his brain works.

It was from Gladwell's book, Outliers, that I first learned about Roseto, Pa. -- a village considered a medical anomaly during the 1950s and '60s because the people suffered little to no heart disease before they reached 65.

And, when they finally began to show signs of cardiac problems, they experienced it at half the rate of other people.

In fact, it seemed that the citizens of Roseto didn't acquire many diseases or disorders at all. Rosetans basically died of old age.

What was the secret behind their good health? It wasn't the usual suspects. It wasn't any particular genetic influence or dietary restrictions, and the lifestyle choices we promote today were virtually absent in Roseto. They cooked with lard, struggled with obesity and smoked at much higher rates than average Americans.

But, there was something a little different about Roseto. Nestled into 0.6 square miles, the inhabitants savored the paesani culture ? as Gladwell described it ? that their forbearers from Roseto Valfortore, Italy established in the 1890's,.

Rosetans knew their neighbors. They enjoyed a great social-support system. They visited with each other. They cared about each other. They respected each other.

It turned out that the good health of the good people of Roseto, Pa., was a byproduct of the place and its rituals, its social customs and values -- and not individual choices and isolated acts.

That spirit of community reminds me of the Hawaiians' sense of 'ohana,' or extended family, which still exists today and I've written about in prior columns.

The Hawaiians' social-support systems may drive the island's No. 1 ranking on the Gallup-Healthways Well-Being Index. Of the six domains that make up the Index, Hawaii is tops in three: life evaluation, emotional health and physical health.

It is this sense of a community's influence on individual and group well-being that moved Healthways Inc., a health and well-being improvement company, to expand its wellness-intervention focus.

"If you focus on the individual and workplace alone, you usually facilitate behavior changes, which typically only last about one year," says Amy Moore, the well-being design leader for Healthways/Blue Zones Vitality Innovations -- a partnership between Healthways and Blue Zones, which is an organization that discovers and provides data based on places where people live measurably longer, happier and disease-free lives.

"But, if you involve the community, change the physical environment and local policies, and make the healthy choice the easy choice, you can experience sustainable change," she says.

Moore says sustained improvement in wellness requires the "trifecta" of individual, employer and community initiatives.

Efforts to create that trifecta are now occurring in a collection of three California cities known as the Beach Cities -- Manhattan Beach, Redondo Beach and Hermosa Beach -- where Healthways/Blue Zones partnered with the Beach Cities Health District to create a Vitality City.

After a year of planning, the initiative -- focusing on the physical, social and emotional pillars of well-being in conjunction with community changes and support -- kicked off on Dec. 1, 2010, with the launch of an employer-outreach element on April 1.

Public-policy changes have focused on adding more places for walking and biking, offering cooking classes and reconsidering the ability of individuals to smoke in outdoor-dining areas.

Less traditional approaches -- drawn from the Blue Zones' data -- are centered on developing social support and helping people feel a sense of purpose.

The Beach Cities recently introduced "walking moais" to create opportunities for individuals to develop friendships while walking through their community. Moai, which means "meeting for a common purpose," originated in Okinawa, Japan (a Blue Zone) as a way for villagers to support each other emotionally in times of need.

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Employers in the Beach Cities are mostly small employers with only a few workers, although there are about 10 to 15 employers with several hundred to several thousand employees, Moore says. That's similar to Hawaii, where 95 percent of employers have fewer than 50 employees.

As part of the employer outreach, the initiative initially targeted the 50 largest employers, including the city governments, high-tech companies, schools and the chambers of commerce.

Businesses that sign up receive free tools, which help them adopt the framework of the pillars of well-being into their workplaces. Their employees also receive an annual Well-Being Assessment (Healthways' proprietary health-risk assessment) and access to QuitNet tobacco-cessation tools at no cost.

Body Glove, a watersports company headquartered in Redondo Beach, signed onto the initiative on Day One.

"We started the weekly lunch as our walking moai," says Russ Lesser, Body Glove's president, as he returned from "Walk to Lunch Wednesday" with the entire HQ staff of 15 employees.

Even though they've only been doing this for a few months, Lesser says he has already seen improvements in productivity and innovation as a result of increased social interaction. He also anticipates a drop in absenteeism.

"I don't need a number to know things are better, but I've witnessed [co-workers] interacting in ways they never normally do," he says.

That's positive for his business and for the community as a whole, he says.

"We're helping our employees develop healthy, vibrant lives and, through this initiative, we believe the Beach Cities will become a more desirable place to live, work and play."

While there are a growing number of public/private wellness programs throughout the United States, the Vitality City initiative is going one step further. Instead of simply challenging employees and citizens to move more and eat less, the Beach Cities -- and the employers within their borders -- are trying to change their community, literally, from the ground up.

With any luck, the Beach Cities will become the next Roseto, Pa.

Carol Harnett is a widely respected consultant, speaker, writer and trendspotter in the fields of employee benefits, health and productivity management, health and performance innovation, and value-based health. Follow her on Twitter via @carolharnett and on her video blog, The Work.Love.Play.Daily.